Retrospective Study of Some Tumors at the Genital Tract of Dogs
Transcription
Retrospective Study of Some Tumors at the Genital Tract of Dogs
Awad Rizk et al., J Vet Sci Med Diagn 2015, 4:2 http://dx.doi.org/10.4172/2325-9590.1000158 Journal of Veterinary Science & Medical Diagnosis Research Article A SCITECHNOL JOURNAL Retrospective Study of Some Tumors at the Genital Tract of Dogs 1*A.Z. Rizk, 2M.F. Hamed and 1A.E. Zaghloul ¹Department of Surgery, Anesthesiology and Radiology, Mansoura University, 35516 Mansoura, Egypt ²Department of Pathology, Faculty of Veterinary Medicine, Mansoura University, 35516 Mansoura, Egypt *Corresponding author: Awad Rizk, Surgery, Anesthesiology and Radiology Department, Faculty of Veterinary Medicine, Mansoura University, 35516 Mansoura, Egypt; Tel: 00201099513339; E-mail: [email protected] Rec date: 26 Aug, 2014 Acc date: Jan 13, 2015 Pub date: Jan 20, 2015 Abstract The objective of the present study was to through light on clinical, histopathological and immunohistochemical (IHC), differential diagnosis as well as evaluation of surgical interventions and outcome of canine external genital tumors. Twenty one cases of canine genital neoplasms (12 vulvar and vaginal tumors and 9 penile and preputial tumors) were recorded. History, clinical, histopathological and IHC examination as well as abdominal ultrasonographic evaluation were performed. The neoplasm's were vaginal leiomyosarcoma [n= 3], perivulvar lipoma [n=1], vaginal cystic polyp [n=1], vulvovaginal adenocarcinoma [n= 2], vaginal transmissible venereal tumour (TVT) [n= 5] as well as penile [n= 3] and preputial [n= 6] TVT, respectively. Local excision with/or without episiotomy was satisfactory with no recurrence of the tumor for about 2 years post-surgery. It was concluded that, surgical excision alone or combined with an episiotomy was successful with no recurrence of the tumour. TVT is rarely metastasis and this really indicated by intense lymphocytic infiltration in dermis of prepuce and vaginal submucosa of our cases. There are no detailed reports of microscopical feature of vaginal cystic polyp in canine. Keywords: Cystic polyp; TVT; Leiomyosarcoma; Perivulvar lipoma; Vagina; Prepuce; Dog Introduction Vaginal and vulvar tumors are the second most common canine female reproductive tumor after those of the mammary gland. They constitute 2.4 - 3% of canine neoplasia [1]; of this 85-90% occur in the vagina and vulva. Most benign tumors are therefore amenable to management by local resection via episiotomy combined with ovariohysterectomy [2]. Leiomyoma, fibroma, and TVT account for most of the canine vulvar and vaginal neoplasms [1]. Other canine vaginal tumors such as adenocarcinoma, epidermoid carcinoma, fibrous histiocytoma, lipoma, myxoma/ myxofibroma, melanoma, mast cell sarcoma, osteosarcoma, papilloma, polyp, hemangiosarcoma, leiomyosarcoma and squamous cell carcinoma are rarely reported [3,4,5]. Vulvar lipoma tends to occur in younger dogs in the age 1-8 years [1,6]. It is not invasive, not aggressive and produces no metastasis to tissues and/or distant organs. Its location in vulvar or peri-vulvar is quite rare and cause local irritation [7, 8]. Vaginal polyps are pedunculated single or multiple structures often arise from the ventral floor of the vagina [9]. Polyps develop from reoccurring edema and fibrosis of proestrus and oestrus in bitches, with the largest developing on the ventral floor cranial to the urethral opening. They can eventually protrude from the vulva where they become ulcerated [9]. Cutaneous apocrine adenocarcinomas are well recognized in dogs and cats [10,11]; they are locally infiltrative with a low metastatic rate. They could occur in the peri-vulval region and would be indistinguishable from primary vulval adenocarcinoma [12, 13, 14]. Canine TVT are an unusual neoplasm occurs in both males and females [15]. Mostly, TVT are solitary or multiple tumors usually appear as cauliflower like growths or as nodules on a stalk. The growths may be multinodular and/or ulcerated [16]. In females, TVT develop in the vagina and on the vulva. In the male dog, the tumor is usually located on the caudal part of the penis and occasionally on the prepuce [17, 18]. TVT is detected in the extragenital regions in dogs at the skin of the perineum, face, side of the thorax, mouth, nasal cavity, limbs and conjunctiva [19,20,21]. The ultimate goal of treatment of the tumor is complete cure, which may be achieved by surgical excision, radiotherapy, immunotherapy and chemotherapy [22]. Radiotherapy has been reported to be effective against TVT, but necessitates chemical immobilization of the dog during the radiotherapy with specialized personnel and equipment [23]. Vincristine sulphate is an effective chemotherapeutic agent in the treatment of TVT despite its many side-effects. Small masses, which are not of typical TVT appearance, can still persist even after a combination therapy with vincristine and doxorubicin. These masses should be removed with surgery [23]. The aim of the present study was to through light on clinical, histopathological and IHC, differential diagnosis as well as evaluation of surgical intervention and outcome of canine external genital tumors. Materials and Methods In recent years, a total number of 21 intact dogs (4- 12 years old) of different breeds were presented with a vulvo-vaginal masses (n= 12) and penile and preputial masses (n= 9) (Table 1). All cases were admitted to Mansoura Veterinary Teachings Hospital of the Faculty of Veterinary medicine, Mansoura University, Mansoura, Egypt. Diagnosis was based up on case history, clinical examination of each overgrowth (includes location, size and shape), abdominal ultrasonography, histopathological, and IHC evaluation. Cases Descriptions Case A (3 bitches) Two German shepherd and one Doberman bitches were referred for evaluation of a mass protruding from the vulvo-vaginal ostium. The finding of clinical examination showed that the mass was round, All articles published in Journal of Veterinary Science & Medical Diagnosis are the property of SciTechnol, and is protected by copyright laws. Copyright © 2014, SciTechnol, All Rights Reserved. Citation: Rizk AZ, Hamed MF, Zaghloul AE (2015) Retrospective Study of Some Tumors at the Genital Tract of Dogs. J Vet Sci Med Diagn 4:2. doi:http://dx.doi.org/10.4172/2325-9590.1000158 hard, necrotic and protruded from vulva. One of these cases associated with partial vaginal prolapse. Case Sex No Age Weight (yr) (Kg) Breed Tumor Location Treatment Recurrence type Follow 2nd treatment Follow-up -up 1 F 8 35 German shepherd LMS Vagina Loc+Epi No 22 mo - - 2 F 11 30 Doberman LMS Vagina Loc+Epi Yes 3 mo Yes 18 mo 3 F 5 5 Lolo LIP Peri-vulvar Loc No 15 mo - - 4 F 6 25 German shepherd VCP Vagina Loc No 20 mo - - 5 F 6 52 Great dane ADC Vagina Loc+Epi No 18 mo - - 6 F 9 75 Great dane ADC Vulvovaginal Loc+Epi No 22 mo - - 7 M 5 45 Great dane TVT Prepuce Loc Yes 6 mo Yes 24 mo 8 M 6 31 German shepherd TVT Penis Loc No 24mo - - 9 F 7 28 German shepherd TVT Vagina Loc+Epi No 18 mo - - 10 F 10 26 German shepherd LMS Vagina Loc No 12 mo - - 11 F 8 27 Doberman TVT Vagina Loc No 15mo - - 12 M 8 33 German shepherd TVT Penis Loc No 12 mo - - 13 M 9 68 Great dane TVT Prepuce Loc No 15mo - - 14 M 6 49 Great dane TVT Penis Loc No 18mo - - 15 M 9 33 German shepherd TVT Penis Loc No 24mo - - 16 M 10 55 Great dane TVT Penis Loc No 14mo - - 17 M 12 62 Great dane TVT Penis Loc No 24mo - - 18 M 8 22 German shepherd TVT Prepuce Loc No 20mo - - 19 F 4 22 German shepherd TVT Vagina Loc No 12 mo - - 20 F 8 30 German shepherd TVT Vagina Loc Yes 12mo Yes 22mo 21 F 9 32 German shepherd TVT Vagina Loc+Epi No 20mo - - Table 1: Showing a patient data including animal species, age, tumour types, treatment, recurrence and follow-up of vulvar, vaginal, penile and preputial neoplasms in dogs F= female M= male dog Loc= local excision Epi= episiotomy LMS= leiomyosarcoma VCP= vaginal cystic polyp LIP= lipoma ADC= adenocarcinoma TVT= transmissible venereal tumor Case B (one bitch) Case C (one bitch) A Lolo bitch was presented with a large ulcerated, round, soft and white looks like perineum mass. Based on history, the mass gradually increased in size over time and sufficiently close the vulva. A German shepherd bitch was presented with the complaint of a moderate abnormal tennis ball sized mass, red, smooth and coneshaped protruding between vulvar lips. It was originated from vaginal wall. Volume 4 • Issue 2 • 1000158 • Page 2 of 7 • Citation: Rizk AZ, Hamed MF, Zaghloul AE (2015) Retrospective Study of Some Tumors at the Genital Tract of Dogs. J Vet Sci Med Diagn 4:2. doi:http://dx.doi.org/10.4172/2325-9590.1000158 Case D (2 bitches) Two Great Dane bitches were referred to our clinic with a history of mass popping out off the vulva since about two months, with a difficulty in urination and defecation. Physical examination revealed a cauliflower growth with a stock like structure originating from the vaginal mucous membrane. Case E (5 bitches) Four German shepherd and one Doberman bitches were admitted with a cauliflower like mass protruded from the vulva (Figure 7A). the secondary biotin-labeled antibody was incubated for 30 min at room temperature. The streptavidin labeled streptavidin-biotin amplification method (cat. NO. KO672, Dako universal LSAB-2 system, USA) was carried out for 30 minutes followed by diaminobenzidine chromagen. The slides were counterstained with hematoxylin. Follow-up: Follow-up information was obtained by visit and telephone inquiries. Owners were questioned about the dog's general health status, recurrence of masses, complications from the surgical procedure, and the ability of the operated animals to urinate freely. Case F (9 male dogs) Results Five Great Dane and four German shepherd male dogs were admitted. Chief complain of the owner was to drops a bloody discharge from the preputial sac just after urination and after prolong siting by the animal. Each animal was breed with 3-4 females in last 2 months. Physical examination after sedation of each animal revealed a pinkish grey cauliflower like, irregular, friable multiple nodular mass located on the prepuce and/ or at base of the penis in a circular fashion. Extragenital lesions on the face, chest and hind limbs were recorded in one of these dogs. In the present study, 21 dogs (12 bitches and 9 male dogs) showed various types of vulvo-vaginal, penile and preputial neoplasms (Table 1). The diagnosed neoplasms were vaginal leiomyosarcoma (n= 3), peri-vulvar lipoma (n= 1), vaginal cystic polyp (n= 1), vulvo- vaginal adenocarcinoma (n= 2) and vaginal (n= 5), penile (n= 3) and preputial (n= 6) TVT. Local excision with or without episiotomy was successful in all cases with no recurrence of the tumor until about 2 year post surgery except three cases (first leiomyosarcoma, second preputial TVT and the third is vaginal TVT) showed recurrence after 3, 6 and 12 months respectively. Surgical excision was performed in the three cases for a second time with successful recovery without recurrence. Two cases of leiomyosarcoma and a case of adenocarcinoma get pregnant after surgery. Abdominal ultrasonographic evaluation: Ultrasonography of the abdomen and mammary gland was performed for detection of tumor metastasis using Shenzhen Mindary (DP-220vet, China) with 5, 7.5 or 10 MHz linear transducer. Surgical interventions: All dogs were premedicated with atropine sulphate in a dose of 0.04 mg/kg body weight (BW) intramuscularly (i.m.) and sedated with xylazine hydrochloride (xylaject, ADWIA, Egypt) in a dose of 1.0 mg/kg BW i.m. Lumbosacral epidural analgesia was performed in 5 dogs using lidocaine 2% (Debocaine, El-Debeaky, Egypt) in a dose of 1ml / 5kg BW. General anesthesia were induced and maintained with the use of thiopental sodium (Thiopental 500 mg vial, EPICO, Egypt) to effect in the rest of cases. Bladder catheterization using a foley catheter (8-10 French) was performed in all bitches. All cases were subjected to local excision of the mass, while in deep seated cases (2 leiomyosarcoma, 2 adenocarcinoma and 2 vaginal TVT) an episiotomy was performed at one o'clock position relative to the dorsal commissure of the vulva (Figure 4B). The mass was easily visualized and it was noted that the vagina was extremely dilated. The growth was resected out. The episiotomy incision was closed by using 2/0 chromic catgut with simple interrupted suture pattern. Skin incision was closed routinely. After owners' consultations, ovariohysterctomy was performed in four bitches. In the case of vaginal cystic polyp, the mass was crushed and legated with an absorbable suture material before surgical excision. Histopathological examination: The excised masses were fixed in 10% neutral buffered formalin, and sent to the pathology laboratory at our University for histopathological examination. Paraffin sections with 5-mm thickness, were prepared routinely and stained with hematoxylin and eosin (H&E) according to [24]. Immunohistochemical (IHC) examination: In order to confirm lieomyosarcoma and cystic polyp, IHC examination were performed using a mouse monoclonal antibody of alpha- smooth muscle actin and desmin respectively. After paraffin removal and hydration, the slides were immersed in 10 mM citrate buffer pH 6, for 15 min for antigen retrieval. The antibodies were incubated overnight at 4°C, and Volume 4 • Issue 2 • 1000158 Case A (leiomyosarcoma): Clinically, the mass appeared firm, white-brown in color and associated with partial vaginal prolapse in one case (Figure 1A). Grossly, on cut section it appeared with multiple nodularity of grayish white to brown in color, firm in consistency and approximately 6 x 4.5 x 4 cm in size (Figure 1B). Histologically, large number of hyper cellular pleomorphic malignant cells which is haphazard in arrangement with tendency to form fasicles. Their nuclei are vesicular and densely basophilic with prominent nucleoli. Some cells retain their spiral shape nuclei and arrangement in bundles (Figure 1D). The IHC staining was uniform in all evaluated sections. Malignant cell stained brown by alpha smooth muscle actin (Figure 1E). Recovery without recurrence was obtained in two cases in about 2 years post-surgery (Figure 1C), while the third case showed regrowth of the mass 3 months post-surgery but less in size. It showed a successful recovery after the second surgery. Case B (Peri-vulvar lipoma): The peri-vulvar mass appeared ulcerated, soft and looks like perineal mass (Figure 2A&2B). On the cut section, it appeared as well capsulated mass with whitish color and fatty in consistency (Figure 2C). Microscopic examination of the tumor revealed well differentiated lipocytes without evidence of malignancy (Figure 2D). Case C (Vaginal cystic polyp): Grossely, the mass appeared red in color and soft in consistency protruding from the vulva (Figure 3A).The histological examination demonstrated cystic dilatation which filled with serous fluid with well differentiated fibro collagenous stroma which has tendency to form whorl shape (Figure 3B). IHC revealed fibrous tissue stained brown positive for desmin for differention from leiomyosarcoma (Figure 3C). Case D (Adenocarcinoma): A cauliflower-like mass showed multiple nodularity, firm in consistency and bulging the vulva out • Page 3 of 7 • Citation: Rizk AZ, Hamed MF, Zaghloul AE (2015) Retrospective Study of Some Tumors at the Genital Tract of Dogs. J Vet Sci Med Diagn 4:2. doi:http://dx.doi.org/10.4172/2325-9590.1000158 (Figure 4A&4C). Histologically, the mass showed cellular atypia, malignant cells has dense basophilic vacuolated nucleus which has tendency to form acini and increase rate of necrosis (Figure 4D). Cases E&F (TVT): It appeared as a cauliflower- like mass (Figure 6A) and (Figure 5A& 5B) at the base of the penis (n= 3), prepuce (n= 6) and vagina (n=5) (Figure 7A). Extra-genital TVT case appeared as a nodular, ulcerated and of variable sizes lesion on the face, thorax and hind limb (Figure 5C). The mean average of each mass measured about 10x 5x4 cm after surgical excision (Figure 6B). Microscopically, in male dogs, large pleomorphic round cells, their nucleus is large vesicular with prominent nuclei. Anaplastic cells arranged radially around blood capillaries (Figure 6D). A large round cell and numerous blood capillaries with lymphocytic infiltration in dermis of the prepuce (Figure 5D). In bitch, sheets of anaplastic cells with little fibrous stroma beside vaginal mucosa infiltrated with lymphocytes (Figure 7B). Sheets of small round anaplastic cells with prominent nucleoli arranged radially around blood vessels were observed (Figure 7C). Penile and preputial masses as well as vaginal mass show successful recovery and outcome after surgical excision (Figure 6C). Figure 1: (A) A large firm mass protruding from vagina with partial vaginal prolapse in a 7 years old German shepherd bitch (B) The cut section of the mass showed multiple nodularity of grayish white to brown in color and firm in consistency (C) Retraction of vagina after removal of the mass and vulva return to normal shape and position (D) Hyper cellularity of pleomorphic malignant cells haphazard in arrangement with tendency to form whorls with densely basophilic and vesicular nuclei with prominent nucleoli and some cells retain their spiral shape nuclei and arrangement in bundles (E) H&E original magnification x 400. Malignant cell stained brown by alpha smooth muscle actin (arrow), (DAB immunostain and HE counter stain) Volume 4 • Issue 2 • 1000158 Figure 2: A 5 years old Lolo bitch showed a well capsulated fatty mass with ulcerated surface at perivulvar region (arrow, A&B). On cut section the mass appeared whitish in color and fatty in consistency (C). Micrograph of perivulvarlipoma in bitch showed a well differentiated lipocytes without evidence of malignancy (D). H&E original magnification x 400 Figure 3: A 6 years old German shepherd bitch with red color mass protruding from the vulva (A). Cystic dilatation of bartholin gland (arrow) with well differentiated fibro collagenous stroma with tendency to form whorl shape (B). Fibrous tissue stained brown positive for desmin. (DAB immunostain, HE counterstain, 10x)(C) • Page 4 of 7 • Citation: Rizk AZ, Hamed MF, Zaghloul AE (2015) Retrospective Study of Some Tumors at the Genital Tract of Dogs. J Vet Sci Med Diagn 4:2. doi:http://dx.doi.org/10.4172/2325-9590.1000158 Figure 4: A 9 years old Great Dane bitch showed a popping out of the vulva (A). An episiotomy incision was performed at one o'clock position (arrow) (B). The mass appeared cauliflower-like growth with multiple nodularity and firm in consistency (C). Hyper cellularity with dense basophilic vacuolated nucleus with tendency to form acini (arrow) and increase rate of necrosis (D) Figure 5: A 7 years old Great Dane male dog showed a cauliflower preputial TVT lesion (A). Another dog showed a nodular TVT lesion on the caudal part of the penis (B). A third dog showed a TVT lesion on the face (C).A large uniform round cells and numerous blood capillaries with lymphocytic infiltration in dermis of the prepuce (D) Figure 6: A 5 years old Great Dane male dog showed a cauliflowerlike growth (arrow) located on the penis and prepuce (A) The mass after surgical excision (B) Slight inflammation of the penis and complete healing of the wound 2 weeks post -surgery (C) A large round cells with vesicular nuclei and prominent nucleoli, arranged in radial pattern around blood vessels with high mitotic rate of division (D) Figure 7:A cauliflower like TVT mass protruding from the vulva in a 4 year old German shepherd bitch (A).Sheets of anaplastic cells with little fibrous stroma beside vaginal mucosa infiltrated with lymphocytes (HE, 4x)(B).Sheets of small round anaplastic cells with prominent nucleoli arranged radially around blood vessels (HE, 10x) (C). Discussion Effective treatment methods for benign tumors of vagina include surgical excision, cryosurgery, immunotherapy and chemotherapy. Although, chemotherapy, radiation therapy or diathermy alone or in combination with surgical excision can also be tried but cryotherapy is found superior due to its analgesic and hemostatic effects, apart from Volume 4 • Issue 2 • 1000158 • Page 5 of 7 • Citation: Rizk AZ, Hamed MF, Zaghloul AE (2015) Retrospective Study of Some Tumors at the Genital Tract of Dogs. J Vet Sci Med Diagn 4:2. doi:http://dx.doi.org/10.4172/2325-9590.1000158 being simple, quick and economical, surgical removal of the tumors is commonly practiced [25]. Surgical excision is the most successful in animals with few, small, circumscribed, accessible lesion with no local invasion or metastases, although the recurrence rate can be as high as 50 - 68% in cases of large invasive tumors [25]. Local treatment primarily involves surgical excision of the mass. Because most tumors arise from the vestibule or the smooth muscle wall of the vagina, they are usually removed per vulva [26,27]. Diagnosis of the tumors mass reported here is based on history, clinical, histopathological and IHC findings. Biopsy for histological examination is the most reliable method for diagnosis. If there is doubt about the histological diagnosis, a definitive diagnosis can be made by IHC studies. Histochemical and electron microscopic studies may be needed for positive identification of the tumour [22]. In this study an episiotomy was performed in deep seated cases of leiomyosarcoma, adenocarcinoma and vaginal TVT, at one o'clock position relative to the dorsal commissure of the vulva to allow easier visualization of the mass. It also assists in the surgical extirpation of extraluminal tumors [1,4,26] . An unusual feature of one case of vaginal leiomyosarcoma was the occurrence of partial vaginal prolapse in bitch. Since it has been found that vaginal tumors are hormone dependent, ovariohysterectomy is the treatment of choice. This also allows examination of the abdominal organs for the presence of metastasis [1]. In this study, after owners' consultations, ovariohysterctomy was performed in four bitches. Vaginal leiomyoma is the most frequently occurring neoplasm particularly in the bitch [1] while leiomyosarcomas are considered uncommon lesions. Unlike our study in which all cases were leiomysarcoma in where cells showing criteria of malignancy. Increase incidence of leiomyosarcoma than leiomyoma may be attributed to unstability in genes or environmental difference, so this needs further studies. A vulvar and vaginal leiomyosarcoma are reported commonly in goats [4] and cows[26]. Thatcher and Bradley (1983) reported that, 10 bitches out of 99 were detected as leiomyosarcoma and only one occurred in a spayed female, in our cases all bitches were also intact when the condition occurred. Immunohistochemical positive staining for alpha-SMA was done to confirm histopathological diagnosis that indicates all cases were leiomyosarcoma. Where alpha-SMA considered a diagnostic feature of genital leiomyosarcomas of domestic animals [28]. Perivlvar lipoma in bitch is properly detected grossly and histopathologically where it arises from perivaginal adipose tissue and form well circumscribed mass. Despite its exaggerated size in this study, the completion of the surgical procedure was uneventful without major difficulties or complications, which is common for this type of neoplasm [29]. The dog had a complication to move due to the size of the tumor, so much so that this was ulcerated due to friction with the ground. The postoperative evaluation was totally favorable. The bitch with perivulvar lipoma had neither difficulty in urinating nor other physiological function, unlike other reports [29,30]. Benign vaginal polyps occur in older bitches [9]. These are usually solitary, measure up to several centimeters in diameter and are attached to the vaginal wall by a thin stalk. Our case is a type of vaginal polyp; it was diagnosed as vaginal cystic polyp. There are no detailed reports of their microscopical feature, where our microscopic examination showed cystic dilation filled with serous fluid and Volume 4 • Issue 2 • 1000158 immunohistochemistry was positive for desmin that differntiate it from leiomyoma . A report of 13 cases of fibro epithelial vaginal polyp in bitches was studied [9]. A metastatic mammary adenocarcinoma, with intralymphatic metastases in the vestibule, has been described in dogs [6,14]. Our cases did not have a history of mammary gland neoplasia and ancillary diagnostics that preceded the surgical excision (abdominal ultrasonography) did not document systemic involvement. At the time of surgery, the mass was localized to the vaginal vestibule. Histopathologically, anaplastic cells tend to form characteristic acini of adenocarcinoma. Local recurrence and/or metastatic disease were not noted on follow-up examination at about 2 years post-surgery. Canine TVT are cauliflower-like, pedunculated, and nodular, may be solitary or multiple and are almost located on the genitalia [17, 18, 31]. Histopathologically it was well diffentiated which complete close to histiocytic origin and characteristic arrangements in sheets or cords radially around blood vessels. They may be transplanted to adjacent skin and oral, nasal, or conjunctival mucosae as seen in a case in the current study. Sometimes the tumor may arise deep within the prepuce or vagina. In the current study, the TVT mass is located on the caudal part of the penis, from the crura to bulbis glandis and on the prepuce as described by [22]. TVT is rarely metastasis and this really indicated by intense lymphocytic infiltration in dermis of prepuce and vaginal submucosa in this study. Surgical resection was performed with a satisfactory results and no recurrence. Surgical resection in combination with L-asparaginase and prednisone may be an option for dogs with TVT that does not respond to standard chemotherapy treatment with vincristine and/or doxorubicin as mentioned by [32]. Conclusion Surgical excision of canine genital tumors alone or combined with an episiotomy was successful with no recurrence. TVT is rarely metastasis and this really indicated by intense lymphocytic infiltration in dermis of prepuce and vaginal submucosa of our cases. There are no detailed reports of microscopical feature of vaginal cystic polyp in canine. References 1. MacLachlan NJ, KennedyPC (2002) Tumors of the genital system. In: Tumors in domestic animals. edn Meuten DJ 4th edn 547–573. 2. 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W.B.Saunders company, Toronto 669-671. 32. Da Silva DM, Reusing MS, Franciosi AI, Belo CEP, Goncalves KA et al. (2014) Treatment of canine transmissible venereal tumor using L-asparaginase, prednisone, and surgery in a clinical chemotherapy-resistant case. Turkish J of Vet and Anim Sci 38:1-4. • Page 7 of 7 •